Introduction
We investigated whether patients in different age groups are influenced by the age, sex, and attire of an orthodontist.
Methods
The opinions of 360 patients regarding 4 orthodontists and 3 types of attire (from photos) were investigated using a questionnaire. Patients were classified as children (8-11 years; n = 120; group 1), adolescents (12-17 years; n = 120; group 2), and young adults (18-25 years; n = 120; group 3). The chi-square test was used to evaluate age- and sex-based preferences for orthodontists and attire types, and a statistical test of proportion (significance level, 5%) was used for multiple comparisons.
Results
Young female orthodontists were preferred (41.1%). A white coat was the preferred attire (48.1%), followed by social clothing (31.7%) and a thematic pediatric coat (19.7%). Groups 1 and 2 preferred a young female orthodontist, whereas group 3 had no apparent age and sex preferences. Regarding attire, group 1 preferred social clothing, whereas groups 2 and 3 preferred a white coat.
Conclusions
Patients of all ages consider appearance to be an important factor when choosing an orthodontist. The participants largely preferred younger professionals who dressed in white coats, because this type of attire was considered clean and hygienic.
Highlights
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The most-liked orthodontists were young and female (41.1%).
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There was a clear preference for young orthodontists (63.3%).
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Female dentists (60%) were preferred compared with male dentists (40%).
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White coat was preferred (48.1%) over social clothing (31.7%) and the pediatric coat (19.7%).
When choosing an orthodontist, patients may consider several factors, including recommendations from other dental professionals and social media marketing. Because more orthodontists in the job market have triggered a higher level of competition, professionals have become more aware of aspects that could improve their ability to attract patients. Some professionals respond by investing more in appearance and marketing; this phenomenon is particularly reflected by social networking.
The initial appointment between a dental professional and a patient is an important contributor to the professional relationship that develops during dental treatment. A dental professional’s appearance is relevant with regard to a good first impression and the promotion of a better and more successful relationship. Therefore, age, sex, and attire may contribute to a patient’s selection : eg. a dentist who wears appropriate attire may give a professional impression, whereas inappropriate attire might suggest negligence and disorganization. However, the patient’s perception of attire may also be influenced by his or her age, as well as the location, setting, and context of care.
Patients and health science professionals have long preferred white attire, which has been used in the medical field since the 19th century. The gradual decrease of the popularity of white attire may lead to many medical professionals wearing more formal clothing, such as suits. This situation is also found in dentistry, where professionals tend to wear alternative attire in both clinical and digital social marketing settings. These may include blazers, suits, ties, and even less formal and colorful wear in pediatric settings.
On 1 hand, physicians who wear white are considered more reliable, experienced, and competent, but on the other hand, younger patients tend to prefer professionals who wear less formal clothing. In orthodontics, various factors play a role in the search for an orthodontist. Although the relatives of pediatric patients may prefer professionals who meet particular criteria for age, sex, and attire, the patients’ own opinions and preferences must also be considered. To our knowledge, no previous study in dentistry has evaluated the perceptions of children, adolescents, and adults about the appearance of dental professionals.
This study aimed to assess the influence of age, sex, and attire of younger patients (ages 8-25 years) in the search for an orthodontist.
Material and methods
This study was approved by the research ethics committee of Sagrado Coração University in Bauru, São Paulo, Brazil (protocol number 1.611.193).
The sample comprised 360 participants (167 male, 193 female) who were divided into 3 groups based on age: group 1 with 120 children aged 8 to 11 years (mean, 9.7 years), group 2 with 120 adolescents aged 12 to 17 years (mean, 14.8 years), and group 3 with 120 young adults aged 18 to 25 years (mean, 20.2 years). This sample size was determined using a power analysis that adopted a significance rate of 5% and a sample power of 80% to yield a minimum difference of 20% between the variables. This analysis indicated that a minimum of 97 participants per group were needed. All participants were students at local schools and universities who required orthodontic treatment. Students without malocclusion were not included in the sample.
Four orthodontists were selected as models: 1 man and 1 woman aged 25 to 30 years, and 1 man and 1 woman aged 40 to 50 years. Five sets of photographs were obtained. Set 1 comprised photographs of the 4 orthodontists (identified as 1-4) wearing polo T-shirts ( Fig 1 ). Sets 2 through 5 included photographs of each orthodontist wearing 3 types of attire: white coat, sex-specific social clothing, and colorful pediatric coat. Sets 2 through 5 corresponded to orthodontists 1 through 4, respectively ( Fig 2 ).
Each participant (n = 360) was interviewed separately using a questionnaire ( Supplemental material ) applied by 1 researcher (A.M.S.-C.), who assisted with the application but did not interfere with the participant’s answers. Each participant analyzed image set 1 and was questioned regarding which orthodontist he or she would choose for treatment. This research step was designed to verify the influences of age and sex on the selection of an orthodontist. The remaining image sets were presented in sequence to investigate the attire preferred by the participants. Data were collected between December 2016 and January 2017.
Statistical analysis
The data were explored descriptively and are presented as absolute (numbers) and relative (percentages) frequencies. The chi-square test was used to investigate the participants’ preferences for the orthodontists (considering age and sex) and types of attire. To evaluate statistically significant differences, a statistical test of multiple comparisons for proportions was applied. All statistical analyses were performed using Statistica software (version 5.1; StatSoft, Tulsa, Okla). A significance level of 5% ( P <0.05) was implemented.
Results
The analysis of the total sample showed a preference for a young female orthodontist (orthodontist 1, 41.1%). As shown in Table I , the preferences for orthodontists 2 (22.2%), 3 (18.9%), and 4 (16.4%) did not differ significantly. Five participants did not express preferences (1.4%). Regarding attire, white coats were preferred significantly (48.1%; P <0.05), followed by formal social clothes (31.7%) and colorful pediatric coats (19.7%), as shown in Table II . However, 0.6% of the sample reported no preference.
| Group | Orthodontist | Total | ||||
|---|---|---|---|---|---|---|
| 1 | 2 | 3 | 4 | No preference | ||
| 1 | ||||||
| n | 74 | 26 | 11 | 9 | 0 | 120 |
| % | 61.7 aA | 21.7 aB | 9.2 aC | 7.5 aC | 0.0 a | 100.0 |
| 2 | ||||||
| n | 41 | 22 | 31 | 22 | 4 | 120 |
| % | 34.2 bA | 18.3 aB | 25.8 bAB | 18.3 bB | 3.3 a | 100.0 |
| 3 | ||||||
| n | 33 | 32 | 26 | 28 | 1 | 120 |
| % | 27.5 bA | 26.7 aA | 21.7 bA | 23.3 bA | 0.8 a | 100.0 |
| Total | ||||||
| n | 148 | 80 | 68 | 59 | 5 | 360 |
| % | 41.1 | 22.2 | 18.9 | 16.4 | 1.4 | 100.0 |
| Group | Attire | Total | |||
|---|---|---|---|---|---|
| 1 | 2 | 3 | No preference | ||
| 1 | |||||
| n | 40 | 51 | 29 | 0 | 120 |
| % | 33.3 aAB | 42.5 aA | 24.2 aB | 0.0 a | 100.0 |
| 2 | |||||
| n | 52 | 44 | 23 | 1 | 120 |
| % | 43.3 aA | 36.7 aAB | 19.2 aB | 0.8 a | 100.0 |
| 3 | |||||
| n | 81 | 19 | 19 | 1 | 120 |
| % | 67.5 bA | 15.8 bB | 15.8 aB | 0.8 a | 100.0 |
| Total | |||||
| n | 173 | 114 | 71 | 2 | 360 |
| % | 48.1 | 31.7 | 19.7 | 0.6 | 100.0 |
In the analysis of age-specific groups, group 1 (children) preferred orthodontist 1 (young woman, 61.7%), followed by orthodontists 2 (young man, 21.7%), 3 (older woman, 9.2%), and 4 (older man, 7.5%). No statistically significant difference was observed between orthodontists 3 and 4 ( P >0.05). In group 2 (adolescents), orthodontist 1 was also preferred (34.2%), followed by orthodontist 3 (25.8%), although this difference was not statistically significant ( P >0.05). Similarly, no significant differences were observed in the preferences of group 2 for orthodontists 2, 3 (18.3%), and 4 (18.3%). Four participants in this group (3.3%) had no preference and stated that appearance should not be considered when choosing an orthodontist because this factor does not reflect professional experience. In group 3 (young adults), although the strongest preferences were distributed between orthodontists 1 (27.5%) and 2 (26.7%), no statistically significant differences ( P >0.05) were observed between the 4 orthodontists, as shown Table I . In this group, only 1 participant did not report a preference (0.8%).
For attire ( Table II ), children preferred social clothing (42.5%), followed by a white coat (33.3%) and a colorful pediatric coat (24.2%), although these differences were not statistically significant ( P >0.05). Among adolescents, white coats were preferred (43.3%), followed by social clothing (36.7%) and the colorful pediatric coat (19.2%), and these differences were statistically significant ( P <0.001). One participant in this group had no preference (0.8%). Among the young adults, the white coat was strongly preferred (67.5%); social clothing and the colorful pediatric coat were each preferred by 15.8% of the group. The preferences for both of the latter types of attire differed significantly from the preference for the white coat. One participant in this group had no preference.
Fourteen variables emerged as justifications for the selection of an orthodontist. The most frequently used variables, as described in Table III , included “experience” (22.3%), “attractive appearance” (18.3%), and “compassion” (15%). The main justifications for selecting orthodontist 1 were “attractive appearance” (26.4%) and “compassion” (20.2%); 13.6% of the participants were uncertain about their justifications. “Attractive appearance” (28.8%) and “compassion” (11.3%) were also reported for orthodontist 2, in addition to “good professional” (11.3%). For orthodontist 3, “experience” (42.6%), “compassion” (14.7%), and “confident” (11.8%) were rated most highly, whereas for orthodontist 4, the justifications relied on most heavily were “experience” (64.4%), “confident” (13.6%), and “compassion” (8.5%).
| Justification | 1 | 2 | 3 | 4 | Total | |||||
|---|---|---|---|---|---|---|---|---|---|---|
| n | % | n | % | n | % | n | % | n | % | |
| Experienced | 7 | 4.7 | 6 | 7.5 | 29 | 42.6 | 38 | 64.4 | 80 | 22.3 |
| Attractive appearance | 39 | 26.4 | 24 | 30.1 | 3 | 4.4 | 0 | 0.0 | 66 | 18.3 |
| Compassionate | 30 | 20.2 | 9 | 11.3 | 10 | 14.7 | 5 | 8.5 | 54 | 15 |
| Uncertain | 20 | 13.6 | 9 | 11.3 | 3 | 4.4 | 2 | 3.4 | 39 | 11 |
| Confident | 3 | 2.1 | 5 | 6.3 | 8 | 11.8 | 8 | 13.6 | 24 | 6.7 |
| Good professional | 8 | 5.4 | 9 | 11.3 | 4 | 5.9 | 1 | 1.7 | 22 | 6.2 |
| Woman | 12 | 8.1 | 0 | 0.0 | 4 | 5.9 | 0 | 0.0 | 16 | 4.4 |
| Younger | 5 | 3.4 | 6 | 7.5 | 0 | 0.0 | 0 | 0.0 | 11 | 3.1 |
| Beautiful smile | 7 | 4.8 | 2 | 2.6 | 0 | 0.0 | 0 | 0.0 | 9 | 2.5 |
| Patient (calm) | 4 | 2.7 | 1 | 1.3 | 0 | 0.0 | 0 | 0.0 | 5 | 1.4 |
| Resembles a dentist | 1 | 0.7 | 1 | 1.3 | 0 | 0.0 | 1 | 1.7 | 3 | 0.8 |
| Hygiene | 2 | 1.4 | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 | 2 | 0.6 |
| Man | 0 | 0.0 | 1 | 1.3 | 0 | 0.0 | 1 | 1.7 | 2 | 0.6 |
| Other | 10 | 6.8 | 7 | 8.8 | 7 | 10.3 | 3 | 5.1 | 27 | 7.5 |
| Total | 148 | 100.0 | 80 | 100.0 | 68 | 100.0 | 59 | 100.0 | 360 | 100.0 |
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